Tuberculosis and Respiratory Diseases

  • 제64권4호
  • /
  • Pages.293-297
  • /
  • 2008
  • /
  • 1738-3536(pISSN)
  • /
  • 2005-6184(eISSN)
대한결핵및호흡기학회 (The Korean Academy of Tuberculosis and Respiratory Diseases)
권호 표지

경구용 항생제 치료로 균음전에 성공한 Mycobacterium fortuitum 폐질환 1예

Successful Treatment of Mycobacterium fortuitum Lung Disease with Oral Antibiotic Therapy: a Case Report

  • 박성훈 (성균관대학교 의과대학 내과학교실, 삼성서울병원 호흡기내과) ;
  • 서지영 (성균관대학교 의과대학 내과학교실, 삼성서울병원 호흡기내과) ;
  • 정만표 (성균관대학교 의과대학 내과학교실, 삼성서울병원 호흡기내과) ;
  • 김호중 (성균관대학교 의과대학 내과학교실, 삼성서울병원 호흡기내과) ;
  • 권오정 (성균관대학교 의과대학 내과학교실, 삼성서울병원 호흡기내과) ;
  • 고원중 (성균관대학교 의과대학 내과학교실, 삼성서울병원 호흡기내과)
  • Park, Sunghoon (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Suh, Gee Young (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Chung, Man Pyo (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Hojoong (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kwon, O Jung (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Koh, Won-Jung (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 투고 : 2008.02.24
  • 심사 : 2008.04.16
  • 발행 : 2008.04.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

M. fortuitum은 호흡기 검체에서 동정되는 경우 대부분 집락화나 일시적인 감염으로 여겨지고 있고, 다른 NTM 폐질환처럼 장기간의 항생제 치료가 필요한 경우는 드물다. 저자들은 객담 항산균 도말과 배양검사에서 강양성을 보이면서, 임상증상과 방사선의 악화소견을 보여 장기간의 경구용 항생제 치료를 실시한 M. fortuitum 폐질환 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Mycobacterium fortuitum usually causes colonization or transient infection in patients with underlying lung disease, such as prior tuberculosis or bronchiectasis. The majority of these patients may not need to receive antibiotic therapy for M. fortuitum isolates. We report here on a patient with M. fortuitum lung disease and who was successfully treated with combination oral antibiotic therapy. A 53-year-old woman was referred to our institution because of purulent sputum and dyspnea. A chest radiograph and computed tomography scan revealed cavitary consolidation in the left upper lobe and multiple small cavities in the left lower lobe. Numerous acid-fast bacilli (AFB) were seen in multiple sputum specimens and M. fortuitum was identified by culture from the sputum specimens. The patient received antibiotic treatment including clarithromycin, ciprofloxacin and sulfamethoxazole, because her symptoms were worsening despite conservative treatment. Sputum conversion was achieved after one month of antibiotic therapy. Both the patient's symptoms and radiographic findings improved after 10 months of antibiotic therapy.

키워드

참고문헌

  1. Wolinsky E. Nontuberculous mycobacteria and associated diseases. Am Rev Respir Dis 1979;119:107-59
  2. Brown TH. The rapidly growing mycobacteria- Mycobacterium fortuitum and Mycobacterium chelonei. Infect Control 1985;6:283-8 https://doi.org/10.1017/S0195941700061762
  3. Wallace RJ Jr, Swenson JM, Silcox VA, Good RC, Tschen JA, Stone MS. Spectrum of disease due to rapidly growing mycobacteria. Rev Infect Dis 1983;5:657- 79 https://doi.org/10.1093/clinids/5.4.657
  4. Koh WJ, Kwon OJ, Jeon K, Kim TS, Lee KS, Park YK, et al. Clinical significance of nontuberculous mycobacteria isolated from respiratory specimens in Korea. Chest 2006;129:341-8 https://doi.org/10.1378/chest.129.2.341
  5. Awe RJ, Gangadharam PR, Jenkins DE. Clinical significance of Mycobacterium fortuitum infections in pulmonary disease. Am Rev Respir Dis 1973;108:1230-4
  6. Griffith DE, Girard WM, Wallace RJ Jr. Clinical features of pulmonary disease caused by rapidly growing mycobacteria: an analysis of 154 patients. Am Rev Respir Dis 1993;147:1271-8 https://doi.org/10.1164/ajrccm/147.5.1271
  7. Park S, Suh GY, Chung MP, Kim H, Kwon OJ, Lee KS, et al. Clinical significance of Mycobacterium fortuitum isolated from respiratory specimens. Respir Med 2008; 102:437-42 https://doi.org/10.1016/j.rmed.2007.10.005
  8. Lee SM, Kim J, Jeong J, Park YK, Bai GH, Lee EY, et al. Evaluation of the broth microdilution method using 2, 3-diphenyl-5-thienyl-(2)-tetrazolium chloride for rapidly growing mycobacteria susceptibility testing. J Korean Med Sci 2007;22:784-90 https://doi.org/10.3346/jkms.2007.22.5.784
  9. Daley CL, Griffith DE. Pulmonary disease caused by rapidly growing mycobacteria. Clin Chest Med 2002;23: 623-32, vii https://doi.org/10.1016/S0272-5231(02)00021-7
  10. Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F, et al. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med 2007;175:367-416 https://doi.org/10.1164/rccm.200604-571ST
  11. Brown-Elliott BA, Wallace RJ Jr. Clinical and taxonomic status of pathogenic nonpigmented or late-pigmenting rapidly growing mycobacteria. Clin Microbiol Rev 2002;15:716-46 https://doi.org/10.1128/CMR.15.4.716-746.2002
  12. Vadakekalam J, Ward MJ. Mycobacterium fortuitum lung abscess treated with ciprofloxacin. Thorax 1991; 46:737-8 https://doi.org/10.1136/thx.46.10.737
  13. Tasaka S, Urano T, Mori M, Yamaguchi K, Kanazawa M. A case of Mycobacterium fortuitum pulmonary disease in a healthy young woman successfully treated with ciprofloxacin and doxycycline. Kekkaku 1995;70: 31-5
  14. Ichiyama S, Tsukamura M. Ofloxacin and the treatment of pulmonary disease due to Mycobacterium fortuitum. Chest 1987;92:1110-2 https://doi.org/10.1378/chest.92.6.1110
  15. American Thoracic Society statement: diagnosis and treatment of disease caused by nontuberculous mycobacteria. Am J Respir Crit Care Med 1997;156:S1-25 https://doi.org/10.1164/ajrccm.156.1.ed08-97
  16. Kim SJ, Hong YP, Bai GH, Kim SC, Jin BW. Nontuberculous pulmonary infection in two patients with Mycobacterium avium-intracellulare complex and a patient with M. fortuitum. J Korean Soc Microbiol 1982; 17:87-93